Before reaching their fifth birthdays, 9.2 million children are reported to have died in 2007, according to the latest child mortatlity figures from UNICEF as published on September 12, 2008 in The Lancet. This figures also highlight the disparity between rich and poor countries around the world
The Millennium Development Goals (MDGs) were established by a large group of members of the United Nations as goals of achievement by the year 2015. The fourth MDG calls for a reduction of at least two-thirds in mortality of children under the age of five. Latest figures show that, generally, high-income countries are on target to meet his, while most poorer countries are not.
Examined by region, certain areas have been more successful than others. For instance, in Latin American and the Caribbean have shown a 53% reduction, Central and Eastern Europe and the Commonwealth of Independent States have shown a 53% reduction, and similarly East Asia and the Pacific with a reduction of 52% all appear to be on track to meet the goal. However, Western and Central Africa has a reduction of 18%, sub-Saharan Africa has a reduction of 21%, and Eastern and southern Africa have a reduction of 26%, indicating they are not on the right track to meet it.
The highest rates of child mortality are found in Western and Central Africa, with 169 deaths per 1,000 live births. Worldwide, child mortality has reduced from 93 deaths per 1,000 in 1990 to 68 per 1,000 in 2007. This is a 27% overall decrease. This is insufficient to reach the MDG4 goal.
There are several notable examples of strong progress in the set of low-income countries. These are most pronounced in Haiti, Eritrea, Laos, Bangladesh, Bolivia, Nepal, Turkmenistan, Mongolia, Botswana, and Azerbaijan, which are all on track to meet the goal. According to the authors of the article link this to the establishment of the Alma-Ata Declaration: “Substantial progress has been made towards the achievement of MDG4; indeed, since the Alma-Ata Declaration in 1978, around 5·5 million children aged less than five years are dying every year.”
They continue, pointing out that there are many strengths and weaknesses in basic health services. For instance, while immunization programs and insecticide-treated bednet programs have been successful, interventions for pneumonia and diarrhea are still behind.
In conclusion, they recommend further development. “In keeping with the original principles of Alma-Ata, more attention will be given to ensure equity for the most underserved as intervention coverage increases. Furthermore, stronger links are being made between UNICEF-assisted health, water and sanitation, nutrition, and HIV programmes. Finally, more investments will be made to monitor, assess, and improve estimation methods…We call upon others to join us in redoubling our efforts to meet these goals, by translating the laudable aspirations of Alma-Ata into the concrete investments and specific evidence-based actions at the country level, that will make the principles of primary health care a reality for the world’s underserved.”
Child mortality 30 years after the Alma-Ata Declaration
Edilberto Loaiza, Tessa Wardlaw, Peter Salama
Lancet Online, Vol 372, September 13, 2008
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Written by Anna Sophia McKenney